鼻息肉组织中嗜酸性阳离子蛋白/髓过氧化物酶、趋化因子配体4、免疫球蛋白E对慢性鼻窦炎伴鼻息肉术后复发的预测价值  

Predictive value of nasal polyps tissues’eosinophilic cationic protein/myeloperoxidase,chemokine ligand 4,and immunoglobulin E in the recurrence of patients with chronic rhinosinusitis with nasal polyps after surgery

作　　者：林秋红[1] 肖祥[1] 张书嘉[1] 韩加辉 董春光[1] LIN Qiuhong;XIAO Xiang;ZHANG Shujia;HAN Jiahui;DONG Chunguang(Department of Otolaryngology and Head and Neck Surgery,the First People’s Hospital of Lianyungang City,Jiangsu Province,Lianyungang 222000,China)

机构地区：[1]江苏省连云港市第一人民医院耳鼻咽喉头颈外科,江苏连云港222000

出　　处：《中国医药导报》2022年第27期106-109,118,共5页China Medical Herald

基　　金：江苏省“333人才工程”科研项目(BRA2020258)。

摘　　要：目的探讨鼻息肉组织中嗜酸性阳离子蛋白(ECP)/髓过氧化物酶(MPO)、趋化因子配体4(CCL4)、免疫球蛋白E(IgE)对慢性鼻窦炎伴鼻息肉(CRSwNP)术后复发的预测价值。方法选择2017年1月至2019年12月于江苏省连云港市第一人民医院行鼻内镜手术治疗的189例CRSwNP患者为研究对象,根据术后2年内是否复发将其分为复发组(26例)与未复发组(163例)。比较两组临床资料及鼻息肉组织中ECP/MPO、CCL4、IgE水平的差异,并进一步分析CRSwNP复发的影响因素及ECP/MPO、CCL4、IgE水平在CRSwNP复发中的临床价值。结果复发组鼻息肉Davos评分、吸烟史占比、术后感染占比及ECP/MPO、CCL4、IgE水平均高于未复发组,差异有统计学意义(P<0.05)。多因素分析结果显示,吸烟、术后感染、ECP/MPO、CCL4、IgE均为CRSwNP患者术后2年内复发的影响因素(P<0.05)。ECP/MPO、CCL4、IgE水平单独及联合对CRSwNP患者术后2年内复发均有一定的预测价值(曲线下面积>0.5,P<0.05)。结论鼻息肉组织中ECP/MPO、CCL4、IgE单独及联合在CRSwNP术后2年内复发的预测中具有临床价值,值得进一步分析探讨。Objective To investigate the predictive value of nasal polyps tissues’eosinophilic cationic protein(ECP)/myeloperoxidase(MPO),chemokine ligand 4(CCL4),and immunoglobulin E(IgE)in the recurrence of patients with chronic rhinosinusitis with nasal polyps(CRSwNP)after surgery.Methods A total of 189 patients with CRSwNP who underwent endoscopic nasal surgery in the First People’s Hospital of Lianyungang City,Jiangsu Province from January 2017 to December 2019 were selected as the research objects.According to the recurrence within two years after surgery,they were divided into recurrence group(26 cases)and non-recurrence group(163 cases).The clinical data and the levels of ECP/MPO,CCL4,and IgE in nasal polyps tissues were compared between the two groups,and the influencing factors of CRSwNP recurrence and the clinical value of ECP/MPO,CCL4,and IgE levels in CRSwNP recurrence were further analyzed.Results The nasal polyps Davos score,the proportion of smoking history,the proportion of postoperative infection,and the levels of ECP/MPO,CCL4,and IgE in the recurrence group were higher than those in the non-recurrence group,and the differences were statistically significant(P<0.05).The results of multivariate analysis showed that smoking,postoperative infection,ECP/MPO,CCL4,and IgE were the influencing factors of recurrence in patients with CRSwNP within two years after surgery(P<0.05).ECP/MPO,CCL4,and IgE levels alone and in combination had certain predictive value for recurrence in patients with CRSwNP within two years after surgery(area under the curve>0.5,P<0.05).Conclusion ECP/MPO,CCL4,and IgE in nasal polyps tissues alone and in combination have clinical value in predicting CRSwNP recurrence within two years after surgery,which is worthy of further analysis and discussion.

关 键 词：鼻息肉组织 嗜酸性阳离子蛋白/髓过氧化物酶 趋化因子配体4 免疫球蛋白E 慢性鼻窦炎伴鼻息肉 复发 预测价值 

分 类 号：R765.4[医药卫生—耳鼻咽喉科]